title: Effects of coronary revascularization with or without cardiopulmonary bypass on plasma levels of asymmetric dimethylarginine.
abstract: OBJECTIVE
  We measured and compared serum asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), and L-arginine levels in patients undergoing coronary artery revascularization.
  
  
  METHODS
  Two groups of patients with coronary artery disease were subjected to coronary artery bypass graft surgery (CABG) with cardiopulmonary bypass (CPB; n = 20) or with off-pump CABG surgery (OPCABG; n = 21). Blood samples for measurements of ADMA, SDMA, and L-arginine were withdrawn and determined by liquid chromatography-tandem mass spectrometry from the coronary sinus (CS) and from the peripheral vein.
  
  
  RESULTS
  On the basis of the intraoperative (CS) samples, ADMA levels rose in the CPB group (F = 0.416, P < 0.685 and F = 14.751, P < 0.001 for OPCABG and CPB groups, respectively). A similar significant increase of ADMA was observed in the peripheral blood (F = 30.738, P < 0.001) during CPB, whereas ADMA levels remained unchanged during OPCABG. The time course of L-arginine levels was significantly different in the blood samples from CS (F = 3.255, P<0.05), when compared with samples from the peripheral blood (F = 3.255, P < 0.05). The values of the L-arginine/ADMA ratio were significantly higher in the OPCABG group at baseline and on the first postoperative day compared with the results of the CPB group (178.29 ± 11.56 vs. 136.28 ± 13.72 and 129.43 ± 7.08 vs. 106.8 ± 6.9 for OPCABG and CPB groups, respectively).
  
  
  CONCLUSIONS
  Plasma levels of ADMA, SDMA, L-arginine, and L-arginine/ADMA ratio are reliable and feasible markers of an early ischemia-reperfusion injury. During CPB operation, the plasma concentration of ADMA increased significantly and remained elevated until the first postoperative day due to extensive ischemia-reperfusion injury caused by CPB.
authors.affiliation: Heart Institute, Faculty of Medicine, Zala County Hospital, Zalaegerszeg, Hungary. acziraki@t-online.hu
authors.forename: Attila
authors.initials: A
authors.lastname: Cziráki
authors.forename: Zénó
authors.initials: Z
authors.lastname: Ajtay
authors.forename: Ádám
authors.initials: Á
authors.lastname: Németh
authors.forename: Zsófia
authors.initials: Z
authors.lastname: Lenkey
authors.forename: Endre
authors.initials: E
authors.lastname: Sulyok
authors.forename: Sándor
authors.initials: S
authors.lastname: Szabados
authors.forename: Nasri
authors.initials: N
authors.lastname: Alotti
authors.forename: Jens
authors.initials: J
authors.lastname: Martens-Lobenhoffer
authors.forename: Csaba
authors.initials: C
authors.lastname: Szabó
authors.forename: Stefanie M
authors.initials: SM
authors.lastname: Bode-Böger
mesh_terms: D000368:Aged; D001120:Arginine / Q000031:analogs & derivatives* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D002315:Cardiopulmonary Bypass; D002851:Chromatography, High Pressure Liquid; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015427:Reperfusion Injury / Q000097:blood; D053719:Tandem Mass Spectrometry
chemical_list: D015415:Biomarkers; C024917:symmetric dimethylarginine; C018524:N,N-dimethylarginine; D001120:Arginine